Uncovering Partners in Crime: The Rise of Complex Fraud and AI-Powered Approaches to Detect It

Sponsored by: Shift Technology (registration to this event is strictly limited by the sponsor)

Due to unforeseen circumstances, this webinar has been rescheduled for Wednesday, October 19 at 1:00pm EST

Sharing patients, prescription kickbacks, collusion, elaborate rings and more – bad actors are teaming up to maximize their reach and return through complex opioid fraud schemes.

Join Shift Technology fraud experts to learn more about these network-based schemes and how to identify and prevent them using today’s advanced AI techniques. 

Attendees will learn:

  • Actionable tactics to identify and prevent complex schemes
  • Common and emerging network-based schemes
  • The basics of network detection
  • Spotting look-alike providers and related alerts

Session host:
Al Culbertson, Product Marketing, Shift Technology

Please note: This event is sponsored by Shift Technology, an NHCAA Platinum Supporting Member. Registration is limited and determined by the sponsor, and NHCAA cannot circumvent or alter the sponsor’s registration policies. Registration from personal email addresses and some organizations are not permitted. Please accept our apologies if you are unable to register for this particular event, however, NHCAA does offer other educational programs. Please click here to view upcoming educational opportunities.

Speakers

Ricky D. Sluder, CFE 
Head of Healthcare Value Engineering Shift Technology

Ricky is a Certified Fraud Examiner and serves as the Head of Healthcare Value Engineering, Americas, at Shift Technology. He is an executive-level leader, with deep subject matter expertise in Healthcare Fraud and White-Collar Crime. He possesses over 25 years of combined experience in law enforcement, CMS ZPIC Healthcare Fraud, Waste, and Abuse Investigations, and business and technology consulting. Ricky has dedicated the last 13 years of his career providing ‘Thought Leadership’ for the design, implementation, and operationalization of several world-class Enterprise Fraud Detection and Prevention Software Solutions in more than 37 US States and seven countries, with returns-on-investment (ROI) measured in the billions (USD).

Mandy Fogle
US Healthcare Value Engineering Lead, Shift Technology

Subject matter expert focusing on improper payments within the Healthcare Industry. Mandy brings 25+ years of experience from enterprise level technology where she led development  and delivery teams of risk management solutions to address client pain points. Her subject matter expertise in these industries provides insight to clients in the area of risk/compliance, fraud, waste, and abuse. As a Value Engineering Lead, Mandy assists clients in the following areas; understanding areas of risk and exposures across organizational hierarchy, gaps in policies and processes, and the value of leveraging AI offerings to address fraud, abuse, and waste within an organization.

Juandiego Marquez
Lead Data Scientist, US Healthcare, Shift Technology

Juandiego has over 10+ years as a Data Scientist with a demonstrated history in the management consulting and technology industries. He is skilled in mathematics, deep learning, and natural language processing. Juandiego currently leads the Usa Healthcare Data Scientist team at Shift with a focus on Healthcare scenarios and AI development to detect fraud, waste and abuse within Healthcare claims.


The event is finished.

Date

Oct 19

Time

Eastern Time
1:00 pm - 2:00 pm
  • CPEs: 1
Shift Technology

Organizer

Shift Technology
Email
alexandra.beswerchij@shift-technology.com

Please email Alexandra Beswerchij with questions.

Login